CONTACT PERSON - LAST NAME FIRST NAME

CONTACT PERSON'S EMAIL   HOME PHONE #

SECONDARY EMAIL ADDRESS

SCIENCE SUPERVISOR'S NAME EXTENSION

SCHOOL NAME     SCHOOL PHONE #   EXTENSION

SCHOOL ADDRESS

STREET & NUMBER    

CITY     STATE     ZIPCODE

SCHOOL WEB ADDRESS

CHECK BELOW WHICH TEAMS YOU WILL BE ENTERING

TOTAL NUMBER OF TEAMS

PLEASE MARK YOUR CALENDAR WITH THESE DATES NOW.

IF YOUR SCHOOL WILL BE CLOSED ON ANY OF THE ABOVE DATES, PLEASE FILL IN THE DATE YOUR SCHOOL WILL BE CLOSED.

OUR SCHOOL WILL BE CLOSED ON     WE WILL MAKE UP THE TEST ON

ON Which date can your school host an exam?

A Coordinator for each area will be selected by the Science League Office prior to the first exam in January.  The responsibilities of the Coordinator are 1. Attend all four exams 2. Keep a list of participating schools in the area, with the name and telephone number of the contact teacher for each school.  3. In the event of inclement weather, where all or only one school might be closed the Coordinator in conjunction with the host teacher will make arrangements for an alternate date and be in contact with the League Office with the information.  If you are able to serve in the capacity, ENTER THAT INFORMATION below.

YOUR NAME    
SCHOOL PHONE # and extension     home phone